Leverstock Green – Application For Enrolment

This form is only to be completed once you have been offered and have accepted a place. For initial enquiries please complete our Enquiry Form on our home page.

All required fields are marked as *

(To be used when someone other than yourself collect your child from the nursery)

(For up to 15- or 30-hours free childcare)

Parent / Carer 1's Details

Parent / Carer 2's Details

PLEASE GIVE DETAILS OF TWO LOCAL ALTERNATIVE EMERGENCY CONTACTS N.B. THESE MUST BE TWO CONTACTS THAT ARE ABLE TO REACH THE SETTING READILY, AND NO LONGER THAN AN HOUR AWAY, IN THE EVENT OF AN EMERGENCY.

Emergency contact 1

Emergency contact 2

CHILD'S HEALTH DETAILS

Injections/immunisations already received:please tick with completed date

I wish my child to attend:

Please tick the box for each day required:

You will be asked to sign below in person when you come for settling-in sessions, please now click Submit at the bottom of this page

AGREEMENT TO CONDITIONS

I accept that prior to my child starting Old MacDonald’s Day Nursery Limited, I must read the Policies & Procedures and sign a Childcare Agreement Form.

Signed .............................. Parent or Guardian Print ......................... Date .........................

I have no objection to still/motion photography being taken of my child for the following purposes:
nursery/student records, my child's own personal records, Email communication with own parents / carers.

Signed .............................. Print ......................... Date .........................

I have no objection to still/motion photography being taken of my child for the purpose of printed or social media.

Signed .............................. Print ......................... Date .........................

I have no objection to still/motion photography being taken of my child by other parents/guardians at nursery events i.e. nativity play.

Signed .............................. Print ......................... Date .........................

I have no objection to my child being recorded on CCTV whilst on nursery premises.

Signed .............................. Print ......................... Date .........................

I give permission for observations to be carried out on my child to help staff and students with on-going training.

Signed .............................. Print ......................... Date .........................

I give permission for my child to go on trips to local places of interest in suitable transport.

Signed .............................. Print ......................... Date .........................

I give permission for my child to be administered Piriton.

Signed .............................. Print ......................... Date .........................

In the event that my child has a temperature of 38°C or higher and the nursery has not yet been able to make contact with me (and it is safe to administer given the time frames and medical advice on the box), I give permission for my child to be administered Calpol as an interim measure to relieve him/her (we will always try to contact a parent first).

Signed .............................. Print ......................... Date .........................

I give permission for my child to receive medical treatment by trained first aid staff and in serious cases (where we would always try to contact a parent first) by a G.P. or hospital.

Signed .............................. Print ......................... Date .........................

Old MacDonald’s Day Nursery Limited’s Privacy Notice for Parents and their Children is available on our website. I acknowledge that I have read and understood the nursery’s Privacy Notice for Parents and their Children.

Signed .............................. Print ......................... Date .........................

I agree for the information on this form to be retained and stored by Old MacDonald’s Day Nursery Limited in accordance with their Privacy Notice for Parents and their Children & GDPR rules.

Signed .............................. Print ......................... Date .........................

I choose to opt-in whoever’s details are submitted on this form to receiving communication from Old MacDonald’s Day Nursery Limited by e-mail, phone and post.

Signed .............................. Print ......................... Date .........................

I agree to inform Old MacDonald's Day Nursery Limited verbally and by e-mail should any of the above details change.

Signed .............................. Print ......................... Date .........................

I understand that any carer that suspects that a child in their care may have been abused or neglected has the duty of care to report this to the relevant body (children’s Services and Ofsted, further details are in our safeguarding policy)

Signed .............................. Print ......................... Date .........................

I have no objection for photos of my child to be used in nursery newsletter that will be distributed to other parents from the nursery only.

Signed .............................. Print ......................... Date .........................